ReviewArthroplasty (London, England)2026
Intra-articular antibiotic delivery combined with one-stage revision for periprosthetic joint infection: a systematic review.
Review in Arthroplasty (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPeriprosthetic joint infection (PJI) is a serious complication after joint arthroplasty requiring surgical and antibiotic management. One-stage revision has gained attention because it reduces the number of procedures while yielding acceptable outcomes. Intra-articular (IA) antibiotic delivery has been investigated to enhance local antimicrobial exposure and address biofilm-related challenges. However, a focused systematic review of IA antibiotic delivery combined with one-stage revision for PJI is lacking. This systematic review evaluated the techniques, safety, and outcomes of this strategy.
methodsA literature search was conducted up to 30 November 2025 across PubMed (including MEDLINE), Web of Science, Embase, and the Cochrane Library. Studies enrolling adults with PJI treated by one-stage revision combined with IA antibiotic delivery and reporting clinical outcomes with at least 12 months of follow-up were included. Study characteristics, treatment protocols, outcomes, and safety data were extracted and descriptively synthesized.
resultsTen studies were identified. IA antibiotic delivery combined with one-stage revision showed satisfactory infection-control outcomes across individual studies. Antibiotics were selected according to microbiological findings and administered via catheter infusion or direct intra-articular injection for 14-42 days. Reported complications were descriptively summarized and included catheter-related, local, surgical, and systemic adverse events. Renal-related adverse events were reported, with no documented long-term renal impairment in the included studies. Heterogeneity in treatment protocols and study designs was noted across studies.
conclusionIntra-articular antibiotic delivery combined with one-stage revision for PJI was associated with satisfactory reported infection-control outcomes and safety findings. While the current evidence is largely retrospective and heterogeneous, further prospective comparative studies with standardized protocols would help clarify its clinical role.
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